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Published in: American Journal of Clinical Dermatology 6/2015

01-12-2015 | Review Article

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: An Update

Authors: Roni P. Dodiuk-Gad, Wen-Hung Chung, Laurence Valeyrie-Allanore, Neil H. Shear

Published in: American Journal of Clinical Dermatology | Issue 6/2015

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Abstract

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous reactions, predominantly drug induced. The mortality rates for SJS and TEN are as high as 30 %, and short- and long-term morbidities are very common. SJS/TEN is one of the few dermatological diseases that constitute a true medical emergency. Early recognition and prompt and appropriate management can be lifesaving. In recent years, our understanding of the pathogenesis, clinical presentation, and management of SJS/TEN has improved. Nevertheless, in 2015, there are still no internationally accepted management guidelines. This review summarizes up-to-date insights on SJS/TEN and describes a protocol for assessment and treatment. We hope these suggested guidelines serve as a practical clinical tool in the management of SJS/TEN. The classic manifestation of SJS/TEN consists of initial “flu-like” symptoms (malaise, fever, anorexia) in the prodromal phase, followed by cutaneous and mucous membrane (ocular, oral, and genital) inflammation and pain, and other systemic involvement. Symptoms usually begin 4–28 days after the onset of drug intake. Treatment is multidisciplinary and includes identification and withdrawal of the culprit drug, transfer to a specialist unit, supportive care, medical treatment, communication, and provision of appropriate information and emotional support.
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Metadata
Title
Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: An Update
Authors
Roni P. Dodiuk-Gad
Wen-Hung Chung
Laurence Valeyrie-Allanore
Neil H. Shear
Publication date
01-12-2015
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 6/2015
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-015-0158-0

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Acknowledgement to Referees

Acknowledgement to Referees